Medical practitioners follow stringent protocols to prevent and manage infections that can spread from one patient to another in a healthcare setting. To aid in the control of these infections, Ocean Informatics offers healthcare facilities a unique software solution that stores, processes, and reports on infection-related data. With SQL Server 2014, Ocean Informatics can cut response time and directly facilitate faster patient care, a critical step in advancing public health and protecting the population.
Superbugs like MRSA and VRE, significant organisms like norovirus and influenza, and notifiable diseases such as measles all pose a risk in the healthcare setting. Hospitals and public health organizations must document and practice a disciplined healthcare delivery system to prevent, monitor, investigate, and manage potential in-facility outbreaks of these kinds of infections. Standard precautions and meticulous surveillance of infection-related events play an essential role in mitigating risk to patients and staff.
To enhance surveillance of healthcare-associated infections, independent software vendor Ocean Informatics developed Multiprac IC, a sophisticated software solution capable of computing and regularly reporting hundreds of standard notifications related to infection-control protocols. Healthcare practitioners use Multiprac IC for the continuous, automated monitoring of blood stream infections, significant organisms, surgical- site infections, outbreak detection and management, and contacts tracing, a process for cataloging patients who come into contact with infection. With this tool, infection-control practitioners can identify adverse trends, implement improvement initiatives, and assess effectiveness of interventions.
Queensland Health of Australia, which operates and administers the state’s public health system, is the largest customer of Ocean Informatics. It uses Multiprac IC and its underlying clinical data repository to process more than 30,000 microbiology and serology pathology results per day (3.5–5 million annually), create 750,000 infection Electronic Health Records (EHRs) per year, and track 1.3 million names of patients who enter the hospital for contact tracing.
The pathology analysis alerts the infection-control practitioners so they can undertake surveillance, deliver appropriate patient care and prevent infections. To do so, the solution must handle intensive business logic processing in the database server, running a number of specific operations against patient data to identify potential risks and create notifications that set off complex processes and work flows. For each of these notifications, the program also reads the patient administration system to locate each patient in the hospital.
“The system generates hundreds of important reports about infections. Because we collect so much data to display on the notification screen, we found that we needed to store and process more transactions than we anticipated. It’s a big system and a lot of processing,” says Joe Griffiths, Engagement Manager for Ocean Informatics.
Sluggish Response Times
When medical staff pull up a dashboard on a computer or hand-held device, they regularly see more than 300 notifications, each of which initiates a round of schedules and examinations. As infection-control practitioners began to increase their use of the system, requirements of the database surged, and those who depend on these reports and notifications began to experience slow performance in the dashboard reporting—sluggishness that then slowed patient-care delivery.
In infection control, a degradation in performance of data retrieval and querying carries with it costly implications—implications that might, quite literally, risk a person’s life. A delay in isolating a patient with a significant infection, such as MRSA or VRE, for example, can increase the chance of cross infection, delay the identification of an outbreak, and lead to a lag in facility-wide contact tracing, an important part of controlling infection in the wider population.
To address what was becoming untenable response times, Ocean Informatics engaged Scalability Experts, a Microsoft partner with a gold competency in data platform, to assess the impact of moving to Microsoft SQL Server 2014 software. By conducting a series of tests in the cloud, Scalability Experts conclusively showed the effect In-Memory OLTP functionality and the new database’s ability to find optimized search paths would have on the end user.
Ocean Informatics was preparing to allocate two months of a full-time employee’s time, plus the effort needed to handle support calls to improve its product. Instead, Scalability Experts worked quickly to upgrade the database to SQL Server 2014, benchmark its performance, and configure the new system for optimal use of memory with minimal disruption to the day-to-day operations of Ocean Informatics or Queensland Health.
“We were going to have to spend a lot of money on projects and coding to improve end-user response time. Just by upgrading the infrastructure to SQL 2014, we solved the problem,” says Griffiths. “The upgrade to SQL Server 2014 let us focus our resources on end-user clinical capability rather than infrastructure. This will improve customer workflows that increase responsiveness to infections.”
The Ocean Informatics upgrade to SQL Server 2014 brought dramatic increases in efficiency and effectiveness to the daily work of infection-control clinical surveillance at Queensland Health and its 57 healthcare facilities launching the solution.
“All the extra intelligence with SQL Server 2014 does what we need in a much more efficient way. So without changing our code, we began to see improvements,” says Griffiths. “We’re talking significant end-user response time improvements.”
Faster Patient Care
The fact that the SQL Server 2014 In-Memory OLTP engine finds data from memory instead of searching caches or disks translates to a fivefold increase in the read time of data transfers from peripheral devices to hospital computers. Customers also see significantly reduced response times: a report that once took 17 seconds now takes only 4 seconds. Faster querying decreases the time for the application webpages to load and for the reports to run, meaning infection-control practitioners can surveil and act at a pace that meets crucial medical and administrative protocols.
“When the system is slow, infection control practitioners cannot be as reactive to important notifications. When a notification comes up in as fast as, say, four seconds, they become more interactive with the system and therefore more responsive to infections and more able to protect other patients,” says Griffiths. “They have a whole new set of efficiencies around infection management.”
Better Business Health
Upgrading to SQL Server 2014 brings not only technological advances to Ocean Informatics but also business advantages. “Our brand reputation for performance is critical,” says Griffiths. “Our customers are waiting eagerly for our new staff health module, and now we can apply our very special skillset to completing the next round of developments on that.”
The server upgrade for Ocean Informatics is concurrent with its move to the Microsoft Azure cloud platform, a move that saves it and its customers significant investment in infrastructure. “Being on Azure means we can configure hybrid solutions working with data on the customer’s premises or in the cloud, which offers huge flexibility especially for training, Disaster Recovery, and testing environments.” says Griffiths.
To build on its improved database management system and cloud capabilities, Ocean Informatics is now preparing to offer its customers self-service business intelligence reporting with Microsoft Power BI. “Analytics will be another powerful tool for investigation, a way to detect trends in infection control in order to gradually reduce overall rates and help the customers become self-sufficient in their reporting.”